VP, LTSS - Health Care Operations (REMOTE)

Job Description

Provides executive level strategy and leadership to drive business performance of long-term services and supports for the enterprise which includes the operational and compliance management of the product line. Works with teams across the enterprise to assess, facilitate, plan, and coordinate best practices that deliver outcomes for members, with a focus on person-centered and strength-based activities of daily living support needs, community integration and stability goals for all populations and member progress towards independence. Analyzes clinical trends, operational / quality performance, and program evaluation that impacts member outcomes and financial performance of the product. Contributes to overarching strategy to provide quality and cost-effective member care.

Supports executive strategy development, vision and direction for enterprise managed long-term services and supports (MLTSS) activities. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.

Provides LTSS expertise to develop and execute strategic, tactical, and operational goals, in partnership with market and LTSS leadership and cross-functional partners, regarding implementation and management of programs that enable older adults and individuals with disabilities to live independently in a setting of their choice while improving health outcomes and quality of life. Ensures the overall level of quality for delivery of LTSS services meets or exceeds appropriate standards.

Partners with operations, markets, and LTSS leadership to develop short and long-term financial and operational plans, as well as appropriate metrics required to strengthen the performance of the organization.

Collaborates with growth leaders and departments across the organization to achieve strategic and corporate business objectives for LTSS business growth.

Assesses, evaluates, and communicates LTSS’s overall performance, drivers of performance, opportunities, and risks, and plans for ensuring program success and reaching business objectives to a variety of audiences.

Ensures that current reporting systems and oversight processes monitor and accurately identify relevant performance issues on a daily, weekly, and monthly basis. This includes both financial and key operating reporting systems and metrics, ensuring systems and processes accurately predict performance issues and allow for timely course corrections. Collaborates with operations leaders to ensure that plans are developed and implemented to address performance issues.

Navigates and influences multiple cross-functional teams in a complex, matrix work environment, fostering and building a collaborative working environment with internal and external colleagues and constituents.

Interprets national and state LTSS policy and regulatory guidance to understand business impact, and ensures programs are established to comply with all relevant federal, state, and local regulations.

At least 12 years of experience in health care leading state Medicaid long-term care services programs in a multi-faceted health plan, health care system, or similar service delivery organization, operational performance management, provider relationships, financial planning and budgeting, strategic planning, risk management, capital generation, revenue management (patient billing, revenue), controllership and internal audit, or equivalent combination of relevant education and experience.

At least 7 years of previous experience managing and developing a team.

Clinical Licensure and / or certification required ONLY if required by state contract, regulation, or state board mandate.

Experience in working across regulatory agencies in program development and implementation.

Experience in working across regulatory agencies in program development and implementation.

Excellent organizational and time-management skills.

Ability to lead change management and cross-enterprise initiatives.

Microsoft Office suite / applicable software program(s) proficiency.

Experience leading a line of business or product line in managed health care.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V.

Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.